Much has been said about reforming Medicare Medicaid and repealing the Affordable Care Act (ACA). Most if not all such proposals merely shuffle a few pieces around and call it reform. Health care reform commonly includes restructuring the cost mechanisms, payment arrangements and/or the processes of doing business. It is similar to when a car manufacturer advertises this year’s make and models as being redesigned. When they merely changed the headlights and added a strip down the side. Isn’t it time for real health care reform.
Reforming Medicare Medicaid is a waste of effort unless reform reverts Medicare to President Truman’s original intent. Insanity is doing the same thing and expecting different results. Medicare reform needs to go beyond cost containment to improving health outcomes.
The worst component of the Affordable Care Act is its combination of private insurance and Medicare Medicaid. Medicare Medicaid because of the problem mentioned above of repeated attempts at reform. Private insurance companies are primarily focused on profit. There is nothing wrong with profits unless it interferes with delivering the best care.
Repealing the Affordable Care Act does nothing to solve the problems of unaffordable insurance, underinsurance, poor diagnostic capabilities, over prescribing medication, excessive testing and escalating cost.
The problem with healthcare in this country is that it has been over-examined based on cost and under-examined based on health outcomes. We should focus more on the cost benefit of healthcare. By improving health outcomes, costs will go down. Why do we pay so much for a system that performs so poorly?
The Affordable Care Act tackles this goal by focusing on prevention and primary care. The Act includes several provisions that focus on wellness education, community engagement and promoting best practices across community boundaries. Prevention should seek to connect stakeholders across the entire spectrum of care. It is not just about medicine. Prevention includes nutrition, physical activity, education and primary care visits.
Upside Down System
Our system of care is upside down; we spend the most on care at the end of life and the least toward keeping and maintaining health. By reversing the current system toward better primary care and more expansive preventative measure outcomes will improve. The cost of care will go down.
We need a national system of care with real-time healthcare monitoring. Control that allows on the spot corrections to achieve better outcomes. An automated system that can track best practices then communicates across communities and spot dangerous outbreaks for faster containment.
Sadly, we have a schizophrenic view of our government’s capabilities and worst a lack of national leadership. On the one hand, we marvel at the sophistication of our military. Then blame government incompetence for the Veterans Administration.
Real Health Care Reform
We have a misguided fascination with private enterprises. The fact is most private companies fail. We equate privatization with competition and competition is compared with better consumer products. However, when it comes to health care, we do not allow insurance companies and medical facilities to compete based on health outcomes. Instead, we allow them to squash competition based on profits. Profit are great but not at the expense of health outcomes.
It is time for real health care reform. Reform that move health outcomes ahead of cost. Profits should rise only after health outcome performance rise. Those producing the best results should be able to charge more their services. The system should compete based on results and performance not based on cost containment. After all, it is called health care.